Resilience and sense of agency among healthcare professionals during crisis

Background and objectives: Healthcare professionals (HCPs) are central to emergency response, and their effectiveness depends not only on clinical expertise but also on psychological resources. Strengthening these resources may sustain workforce capacity and safeguard care under crisis conditions. This study examined the contribution of psychological capital-particularly resilience-to perceived agency among Israeli HCPs during mass casualty incidents and violent conflict after 7th of October 2023. The objective was to assess whether psychological resources predict perceived effectiveness beyond traditional factors, with implications for preparedness, organisational support, and policy. Findings may inform interventions relevant to resource-restricted environments and adaptable to developing countries. Methods: The study was designed as an observational-cross-sectional study, conducted using encrypted online questionnaires distributed via QR codes in trauma centres, dispatch stations, and professional forums. Participants were qualified physicians, surgeons, nurses, paramedics, and EMTs providing patient care during the conflict. Instruments measured psychological capital (PCQ-24), resilience (CD-RISC 10), and perceived agency (RSES). Results: = 0.022). Conclusion: Psychological capital and resilience are key determinants of HCPs' perceived agency in crises. Embedding resilience-building into public health systems, alongside organisational and policy measures, may enhance workforce readiness across conflict, disaster, and health threats. These findings are especially relevant to resource-limited settings, where psychological preparedness may be a cost-effective means to support frontline staff and sustain delivery.